血尿酸水平与阵发性心房颤动的关系

Assciation between uric acid levels and paroxysmal atrial fibrillation

目的探讨阵发性心房颤动与血尿酸水平的关系。方法连续入选2011年9月至2012年6月在天津医科大学第二医院心脏科住院的阵发性心房颤动患者65例，同期住院的非心房颤动患者41例作为对照组，排除心力衰竭、急性冠状动脉综合征、先天性心脏病、心脏瓣膜病、心肌病、甲状腺功能障碍、急性感染与炎症等，详细记录入选患者的一般临床资料特征、合并疾病、实验室检查结果，采用经胸多普勒心脏超声测定左心房前后径、左心室舒张末期内径和左心室射血分数等；采用单因素分析及Logistic回归分析阵发性心房颤动发生的危险因素。结果阵发性心房颤动组血清尿酸较对照组明显升高[分别为（360．2±103．9）、（296．0±68．1）μmol／L，P=0．001]。多元Logistic回归分析显示，高尿酸水平、左心房扩大为阵发性心房颤动发生的独立危险因素[uA：OR（95％CI）1．007（1．000～1．015），LAD1．142（1．031—1．265）]。结论高尿酸血症是阵发性心房颤动的独立危险因素之一。两者之间联系的可能机制有待于进一步研究。

Objective To investigate the potential relationship between the paroxysmal Atrial Fibrillation （PAF） and serum uric acid level. Methods Consecutive patients with （patient group, n = 65 ） and without （control group, n = 41 ） PAF, who were hospitalized in the Second Hospital of Tianjin Medical University from September 2011 to June 2012, were included in this study. We excluded subjects with congestive heart failure, acute coronary syndrome, congenital heart disease, valvular heart disease, cardiomyopathy, thyroid dysfunction and acute infection or inflammatory conditions. Baseline clinical data, complications and laboratory examination results were collected. Left atrium diameter （LAD）, left ventricular end-diastolic dimension （LVEDD） and left ventricular ejection fraction （LVEF） were determined by echocardiography. Univariate and logistic regression was conducted to detect risk factors for PAF. Results Serum uric acid level were significantly increased in patients with PAF compared with controls （ （ 360. 2 -＋ 103.9 ） μmol/L vs （ 296. 0 ＋ 68. 1 ） pLmol/L,P = 0. 001 ）. Multivariate logistic regression analysis showed that higher level of serum uric acid （ OR： 1. 007,95 % CI： 1. 000 - 1. 015 ） and LAD （ OR： 1. 142,95% CI： 1.031 - 1. 265 ） were independent risk factors for the occurrence of PAF. Conclusion High serum uric acid level is an independent risk factor for the development of PAF. Future larger studies should further evaluate this potential association as well as the underlying mechanisms.